Victory Physical Therapy and Rehab

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

VICTORY PHYSICAL THERAPY AND REHAB

Practice address

989 Sanford Ave
Irvington, NJ 07111-1444

Phone

(973) 900-3210

NPI assigned

Apr 11, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Victoria AdeyinkaNPI 1275092330

Title

Physical Therapist

Phone

(973) 900-3210

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Victoria Adeyinka

  • Physical Therapist
  • Irvington, NJ
  • NPI 1275092330
  Medicare reassignment Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1554940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554940800000",
    "number": "1649733080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54 FERNWOOD RD",
            "city": "MAPLEWOOD",
            "state": "NJ",
            "postal_code": "070401622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "989 SANFORD AVE",
            "city": "IRVINGTON",
            "state": "NJ",
            "postal_code": "071111444",
            "telephone_number": "973-900-3210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTORY PHYSICAL THERAPY AND REHAB",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-11",
        "last_updated": "2019-04-11",
        "status": "A",
        "authorized_official_last_name": "ADEYINKA",
        "authorized_official_first_name": "VICTORIA",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "973-900-3210"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapy Clinic/Center in Irvington, NJ
• Providers in Irvington, NJ by specialty
• Physical Therapy Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.